By Reneva Fourie
It is fitting that we close ‘Women’s Month’ by applauding South Africa’s health workers. Globally, 70 percent of the nurses and general workers in the health sector are women.
Health workers are among the most affected by the current challenges befalling our country, be it the Covid-19 pandemic, the crisis of social reproduction, or our ailing economy.
The Covid-19 pandemic has hopefully reached its peak in South Africa and we have been able to move to level 2 due to the decline in the rate of new infections. Despite the decline, the number of new infections still exceed 1 000 a day, with the total number of Covid-19 positive cases still being well over 600 000 and the death toll over 5 000 persons.
Health workers have been at the forefront of fighting this pandemic, working long hours to provide care and support to the infected, in addition to the usual expected healthcare services. It is thanks to this selfless dedication that more than 500 000 people have recovered fully from Covid-19 to date. They daily, willingly, risk their own health and that of their families so that our lives might be spared. The costs are high, for according to nurses’ union Denosa, as at August 2020, twenty-four thousand South African health care workers have tested positive for Covid-19 and more than 180 have died.
The Covid-19 pandemic has deepened poverty, inequality and unemployment in society. As a consequence, those elements that must ensure positive social conduct and relations, as well as the cohesion of the fabric of society are unravelling, resulting in a crisis of social reproduction. Depression and suicide attempts are on the rise as mental health takes a strain; and violent crime remains pervasive.
Health workers are our first port of call for care for trauma victims, survivors of gender-based violence, and counselling of abusers of drugs and alcohol. The Department of Health in the Western Cape stated in July 2020, following the lifting of the first ban on alcohol sales, “The lifting of the alcohol ban has effectively resulted in a 62 percent increase in daily trauma cases presenting to emergency centres. In addition, we have seen trauma admissions increase by 54 percent, trauma ICU admissions increase by 350 percent and trauma deaths in the [emergency centres] increase by 308 percent”. While health workers are not immune to these manifestations of the crisis of social reproduction, they are still expected to provide quality, compassionate care.
Health workers are also disadvantaged economically. Most are poorly paid and are subjected to poor working conditions. Their situation is exacerbated by the outsourcing of health care services and the continued rise of private hospitals. As government increases the role of the private sector in what should be a fundamental public service, the vulnerability of health care workers increases.
South Africa spends 8.5 percent of GDP on health [2018], yet very little of that money goes to workers and patients. Most public hospitals have outsourced services such as catering, cleaning and security. Even nursing staff are sometimes sourced via an agency. Health care workers consequently have little job security, lose out on benefits, and earn a pittance, while the broker lives comfortably. The outsourcing also weakens accountability as the health care services are increasingly fragmented and an uncontrolled commercialism is introduced, thereby undermining health as a public good.
Likewise, the unfettered sprouting of private hospitals associated with health conglomerates is a concern. It pushes up the price of health care, making health care unaffordable to the poor, whilst still leaving workers vulnerable.
The most vulnerable however are the health care facilities attached to well-meaning non-governmental organisations. Workers at the entities work equally hard; they provide exemplary quality services which are highly valued in the communities that they serve, yet they are not guaranteed a salary at the end of the month as their incomes are dependent on donations.
The focus today, therefore, should be on health workers. We should applaud them for successfully carrying us through the Covid-19 pandemic. We should applaud them for being our source of refuge when the social structure of society crumbles. And we should express our applause and appreciation by offering them decent conditions of service.
Government should not be skimpy, nor hesitant to offer our health workers an increase. Services in public hospitals should be insourced so that workers can have job security; and the dominance of private conglomerates in the health sector must be curtailed. At the same time, government should be at the forefront of ensuring that NGOs that provide health services are adequately funded.
Our health workers deserve more than lip service. Show that we appreciate them by paying them well.
* Reneva Fourie is a policy analyst specialising in governance, development and security and currently resides in Damascus, Syria.
** The views expressed here are not necessarily those of IOL.